ArticleFrontiers in oncology2026
Laparoscopic transabdominal approach for radical excision of low-lying presacral cyst: a case report and narrative mini-review.
Article in Frontiers in oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Presacral cysts are clinically rare, deeply located, and pose diagnostic challenges prior to surgery. Complete surgical resection is the primary treatment. Laparoscopic techniques offer minimally invasive advantages; however, the feasibility and safety of the transabdominal approach for low-lying cysts remain to be fully evaluated. Through this case report and narrative mini-review, this study aims to assess the technical characteristics and value of this approach. Clinical presentation: A 39-year-old female patient, with a history of constipation, no other significant medical history, and a prior cesarean section, presented due to a presacral cystic mass discovered during a routine gynecological ultrasound. She reported no specific discomfort such as abdominal distension or pain. Contrast-enhanced abdominopelvic CT revealed a cystic, low-density lesion in the presacral region (approximately 8.3 cm × 6.2 cm, with a pre-contrast CT value of about 28 HU), showing no significant enhancement. Pelvic MRI demonstrated that the cystic lesion exhibited slightly low signal on T1-weighted images (T1WI), slightly high signal on T2-weighted images (T2WI), markedly high signal on diffusion-weighted imaging (DWI), and low signal on apparent diffusion coefficient (ADC) map. The superior pole of the cyst was at the level of the coccyx. Digital rectal examination revealed a soft mass posterolateral to the rectum. After multidisciplinary discussion and thorough communication with the patient, a laparoscopic exploration was decided upon. Intraoperatively, a well-defined cystic tumor was visualized posterior to the rectum and was completely resected. Postoperative pathological diagnosis confirmed a (presacral) epidermoid cyst. At the 3-month follow-up, the patient recovered well with no recurrence or complications. Conclusion: The laparoscopic transabdominal approach appears feasible for radical excision of low-lying presacral cysts in selected patients when performed by experienced surgeons. Long-term follow-up is required to confirm recurrence outcomes.
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